<!DOCTYPE html>
<html lang="zh" xmlns:th="http://www.thymeleaf.org" >
<head>
    <th:block th:include="include :: header('1+1+1签约详情')" />

</head>
<body class="white-bg">
<div class="wrapper wrapper-content animated fadeInRight ibox-content">
    <form class="form-horizontal m" id="form-fqy-detail" th:object="${fqy}">
	
	        <!--签约编码-->
        <div class="form-group col-sm-12 hidden">
            <div class="col-sm-4 text-right">签约编码：</div>
            <div class="col-sm-8">[[*{qyid}]]</div>
        </div>

        <!--签约编号-->
        <div class="form-group col-sm-12">
            <div class="col-sm-4 text-right">签约编号：</div>
            <div class="col-sm-8">[[*{qybh}]]</div>
        </div>

        <!--社区编码-->
        <div class="form-group col-sm-12 hidden">
            <div class="col-sm-4 text-right">社区编码：</div>
            <div class="col-sm-8">[[*{sqid}]]</div>
        </div>

        <!--社区名称-->
        <div class="form-group col-sm-12">
            <div class="col-sm-4 text-right">社区名称：</div>
            <div class="col-sm-8">[[*{sqmc}]]</div>
        </div>

        <!--区级医院编码-->
        <div class="form-group col-sm-12 hidden">
            <div class="col-sm-4 text-right">区级医院编码：</div>
            <div class="col-sm-8">[[*{qjid}]]</div>
        </div>

        <!--区级医院名称-->
        <div class="form-group col-sm-12">
            <div class="col-sm-4 text-right">区级医院名称：</div>
            <div class="col-sm-8">[[*{qjmc}]]</div>
        </div>

        <!--市级医院编码-->
        <div class="form-group col-sm-12 hidden">
            <div class="col-sm-4 text-right">市级医院编码：</div>
            <div class="col-sm-8">[[*{sjid}]]</div>
        </div>

        <!--市级医院名称-->
        <div class="form-group col-sm-12">
            <div class="col-sm-4 text-right">市级医院名称：</div>
            <div class="col-sm-8">[[*{sjmc}]]</div>
        </div>

        <!--医生工号-->
        <div class="form-group col-sm-12">
            <div class="col-sm-4 text-right">医生工号：</div>
            <div class="col-sm-8">[[*{ysgh}]]</div>
        </div>

        <!--医生身份证-->
        <div class="form-group col-sm-12">
            <div class="col-sm-4 text-right">医生身份证：</div>
            <div class="col-sm-8">[[*{yssf}]]</div>
        </div>

        <!--医生姓名-->
        <div class="form-group col-sm-12">
            <div class="col-sm-4 text-right">医生姓名：</div>
            <div class="col-sm-8">[[*{ysxm}]]</div>
        </div>

        <!--居民编码-->
        <div class="form-group col-sm-12 hidden">
            <div class="col-sm-4 text-right">居民编码：</div>
            <div class="col-sm-8">[[*{jmid}]]</div>
        </div>

        <!--居民身份证-->
        <div class="form-group col-sm-12">
            <div class="col-sm-4 text-right">居民身份证：</div>
            <div class="col-sm-8">[[*{jmsf}]]</div>
        </div>

        <!--居民医保卡-->
        <div class="form-group col-sm-12">
            <div class="col-sm-4 text-right">居民医保卡：</div>
            <div class="col-sm-8">[[*{jmyb}]]</div>
        </div>

        <!--居民姓名-->
        <div class="form-group col-sm-12">
            <div class="col-sm-4 text-right">居民姓名：</div>
            <div class="col-sm-8">[[*{jmxm}]]</div>
        </div>

        <!--居民电话-->
        <div class="form-group col-sm-12">
            <div class="col-sm-4 text-right">居民电话：</div>
            <div class="col-sm-8">[[*{jmdh}]]</div>
        </div>

        <!--居民地址-->
        <div class="form-group col-sm-12">
            <div class="col-sm-4 text-right">居民地址：</div>
            <div class="col-sm-8">[[*{jmdz}]]</div>
        </div>

        <!--签约时间-->
        <div class="form-group col-sm-12">
            <div class="col-sm-4 text-right">签约时间：</div>
            <div class="col-sm-8">[[*{qysj}]]</div>
        </div>

        <!--有效期-->
        <div class="form-group col-sm-12">
            <div class="col-sm-4 text-right">有效期：</div>
            <div class="col-sm-8">[[*{yxqx}]]</div>
        </div>

        <!--签约内容-->
        <div class="form-group col-sm-12">
            <div class="col-sm-4 text-right">签约内容：</div>
            <div class="col-sm-8">[[*{qynr}]]</div>
        </div>

        <!--签约备注-->
        <div class="form-group col-sm-12 hidden">
            <div class="col-sm-4 text-right">签约备注：</div>
            <div class="col-sm-8">[[*{qybz}]]</div>
        </div>

        <!--备注项00-->
        <div class="form-group col-sm-12 hidden">
            <div class="col-sm-4 text-right">备注项00：</div>
            <div class="col-sm-8">[[*{bz00}]]</div>
        </div>

        <!--备注项01-->
        <div class="form-group col-sm-12 hidden">
            <div class="col-sm-4 text-right">备注项01：</div>
            <div class="col-sm-8">[[*{bz01}]]</div>
        </div>

        <!--备注项02-->
        <div class="form-group col-sm-12 hidden">
            <div class="col-sm-4 text-right">备注项02：</div>
            <div class="col-sm-8">[[*{bz02}]]</div>
        </div>

        <!--备注项03-->
        <div class="form-group col-sm-12 hidden">
            <div class="col-sm-4 text-right">备注项03：</div>
            <div class="col-sm-8">[[*{bz03}]]</div>
        </div>

        <!--备注项04-->
        <div class="form-group col-sm-12 hidden">
            <div class="col-sm-4 text-right">备注项04：</div>
            <div class="col-sm-8">[[*{bz04}]]</div>
        </div>

        <!--备注项05-->
        <div class="form-group col-sm-12 hidden">
            <div class="col-sm-4 text-right">备注项05：</div>
            <div class="col-sm-8">[[*{bz05}]]</div>
        </div>

        <!--备注项06-->
        <div class="form-group col-sm-12 hidden">
            <div class="col-sm-4 text-right">备注项06：</div>
            <div class="col-sm-8">[[*{bz06}]]</div>
        </div>

        <!--备注项07-->
        <div class="form-group col-sm-12 hidden">
            <div class="col-sm-4 text-right">备注项07：</div>
            <div class="col-sm-8">[[*{bz07}]]</div>
        </div>

        <!--备注项08-->
        <div class="form-group col-sm-12 hidden">
            <div class="col-sm-4 text-right">备注项08：</div>
            <div class="col-sm-8">[[*{bz08}]]</div>
        </div>

        <!--备注项09-->
        <div class="form-group col-sm-12 hidden">
            <div class="col-sm-4 text-right">备注项09：</div>
            <div class="col-sm-8">[[*{bz09}]]</div>
        </div>

        <!--备注项10-->
        <div class="form-group col-sm-12 hidden">
            <div class="col-sm-4 text-right">备注项10：</div>
            <div class="col-sm-8">[[*{bz10}]]</div>
        </div>

        <!--备注项11-->
        <div class="form-group col-sm-12 hidden">
            <div class="col-sm-4 text-right">备注项11：</div>
            <div class="col-sm-8">[[*{bz11}]]</div>
        </div>

        <!--备注项12-->
        <div class="form-group col-sm-12 hidden">
            <div class="col-sm-4 text-right">备注项12：</div>
            <div class="col-sm-8">[[*{bz12}]]</div>
        </div>

        <!--备注项13-->
        <div class="form-group col-sm-12 hidden">
            <div class="col-sm-4 text-right">备注项13：</div>
            <div class="col-sm-8">[[*{bz13}]]</div>
        </div>

        <!--备注项14-->
        <div class="form-group col-sm-12 hidden">
            <div class="col-sm-4 text-right">备注项14：</div>
            <div class="col-sm-8">[[*{bz14}]]</div>
        </div>

        <!--备注项15-->
        <div class="form-group col-sm-12 hidden">
            <div class="col-sm-4 text-right">备注项15：</div>
            <div class="col-sm-8">[[*{bz15}]]</div>
        </div>

        <!--备注项16-->
        <div class="form-group col-sm-12 hidden">
            <div class="col-sm-4 text-right">备注项16：</div>
            <div class="col-sm-8">[[*{bz16}]]</div>
        </div>

        <!--备注项17-->
        <div class="form-group col-sm-12 hidden">
            <div class="col-sm-4 text-right">备注项17：</div>
            <div class="col-sm-8">[[*{bz17}]]</div>
        </div>

        <!--备注项18-->
        <div class="form-group col-sm-12 hidden">
            <div class="col-sm-4 text-right">备注项18：</div>
            <div class="col-sm-8">[[*{bz18}]]</div>
        </div>

        <!--备注项19-->
        <div class="form-group col-sm-12 hidden">
            <div class="col-sm-4 text-right">备注项19：</div>
            <div class="col-sm-8">[[*{bz19}]]</div>
        </div>

 


    </form>
</div>
<th:block th:include="include :: footer" />
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</body>
</html>
